Asymptomatic athlete with bradycardia

20 May 2014

Organised by:

The case

Description

17-year-old male athlete was referred for specialist investigation after an abnormal ECG on routine pre-participation cardiac evaluation.
He had been participating in competitive exercise since the age of 12 years.
His current regime consisted of swimming for 20 hours and cycling for 6 hours per week.
He was asymptomatic. There was no past medical or family history of note.
He denied recreational or performance enhancing drug use. Cardiac examination identified bradycardia of 40 beats per minute.
A transthoracic echocardiogram revealed a structurally normal heart.

The 12-lead ECG is shown below.

References

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[*6]Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists.
Baldesberger S, Bauersfeld U, Candinas R, Seifert B, Zuber M, Ritter M, Jenni R, Oechslin E, Luthi P, Scharf C, Marti B, Attenhofer Jost CH. Eur. Heart J. 2008; 29:71–8.

Notes to editor

Dr Nabeel Sheikh, Cardiology Research Fellow
Dr Michael Papadakis, Lecturer in Cardiology, St George’s University of London
Prof Sanjay Sharma, Professor of Clinical Cardiology, St George’s University of London